My husband wanted me to ask what is urinary incontinence exactly? Does it mean that you know the urine is coming and you can't stop it or does it mean that you don't even know that the urine is coming?

**"Report to the Nation on Prostate Cancer" published by the Prostate Cancer Foundation, page 11: "In some cases, the pathologist might identify a third pattern, which is less common but that has a higher grade than either of the first two patterns that comprised the Gleason score. The presence of this third pattern might indicate that the tumor is more aggressive than the Gleason score would otherwise imply. For example, if a Gleason 4+3 tumor also has some grade 5 cells, the cancer would be considered as being of higher grade disease overall."

Maria, my laymen's definition is a range in symptom: From total lack of urinary control to an occasional small drip that seems to happen on its own.

Post surgery and catheter removal, most man have little bladder control. Depending on the type and severity of the surgery, two of the three ways men control their bladder release have been removed. The least used and weakest control mechanisms is the rectum, which, post-surgery, takes over as the only control. It has to build up strength and you have to train your body to this function.

After you regain some control, it happens that you drip or have a small release of urine when you stand up, move quickly, sneeze or "break wind" to say it politely. Over time, it gets better as your body heals and adjusts. I just posted being dry for 2-3 days in a row, this morning, I've had a drip or two. So over time I expect to be rid of the pads.

Finally, I think it is harder on us men to admit that we can't control this part of our body, that we have to let the healing take place and it takes time! IMHO, being a little incontinent is a whole lot better than not knwoing about the cancer and the resultant illness.

My best to you and your husband, we will be praying for you for success in the surgery.Age: 56

PSA: 4.1 (first test) 4.2 (second test)

Gleason: 6, cancer found in both sections of prostate

Surgery: Open RP on 5/1/07

Pathology: All contined with the gland, no spread

Catheter out: 5/15/07

Incontinence: at 10 weeks to one pad per day

ED: slowly getting better

First Post-Surgery PSA: 8/6/07 Results <.01 !!

Spread the word to men you know or meet: See your doctor. Have a PSA test early.

Hi Maria Teresa: It's a bit of both. Sometimes you know it's coming and sometimes you don't. Sometimes you can stop it and sometimes you can't. That's why it is such a pain in the neck. Like Wamba said, the sneeze, the unexpected cough, a false move of some kind.....and the floodgates can open. But, as time went by and I continued to sneeze, cough and make those false moves from time-to-time, I regained control. I wore pads through week six, as a precaution.

And the kegels are important.

It gets better with time. Very few guys have big problems after a few weeks out of surgery, although for many of us, there will be unexpected little drips for the rest of our lives. But most of us had those before surgery anyway. Right fellas?

Here's an expression I saw scrawled above a urinal at the City College of New York many years ago:

"No matter how much you shake and dance, the last drop always lands in your pants!"

**"Report to the Nation on Prostate Cancer" published by the Prostate Cancer Foundation, page 11: "In some cases, the pathologist might identify a third pattern, which is less common but that has a higher grade than either of the first two patterns that comprised the Gleason score. The presence of this third pattern might indicate that the tumor is more aggressive than the Gleason score would otherwise imply. For example, if a Gleason 4+3 tumor also has some grade 5 cells, the cancer would be considered as being of higher grade disease overall."

You probably don't want to read my story before surgery due to my long term incontenance. I hope you are in the normal group and dry up in a few months. What is Incontenance? In my case it can be confusing! I can sit and sleep with little to no leaking. I get the urge to go when my bladder get's full and have good control with a full bladder. But, if I empty and stay on my feet I have no control. I feel the leaks and squirts when ever they happen but not before. I do retain a small amout of urine while standing and moving around but there is no urge to go.

Hope this helps. Good Luck with your Journey.

KW 43

PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.

Gleason 7

Biopsy - 3 of 12 positive (up to 75%) all on left side of prostate

RRP on Oct. 17, 2006 - Nerves on right side saved.

All Lab's clear. No Cancer outside prostate

Cathiter in for 3 weeks due to complications in healing. Removed Nov. 9, 2006

First Post op PSA on Dec. 11, 2006 Undetectable 0.00

Office visit on Jan. 19th due to continued excessive urine leakage.

Feb.20th Cystoscope and 2nd Post Op PSA. Another 0.00.....:)

Dr. said everything looks fine. Continue to work Kegeal's. Leaking appears to have improved after Cystoscope?!?!?! Down to 3-4 pads per day!

March 1st Leaking has crept back up to 6 - 8 pads a day ???????

March 8th Started Detrol LA to see if it helps with the leaking?

March 29th Collagen injection into sphincter / bladder neck area to control excessive leaking. Worked for a couple of days then back to leaking.

April 17th (Six Months Post Op) 2nd Collagen Injection to control excessive leaking. Leaking started back next day at work!

May 14th Second Opinion about my leaking and Options at OU Medical Center. After reviewing my records the Dr. feels I will probably need some surgical intervention to stop my leaking. But did agree to try Bio-Feedback and work hard on the Kegeal's first!

That is a good question. When I had my cath removed it was like opening the flood gates. When I left the hospital urine was runnign down my leg and dripping on the floor because I had a small pad and walking that short distance was not very good for my ego. My wife went to the drug store for some heavy duty pads and that was better. I am really jealous of those guys who have had no problem with dripping. After 3 months I am a lot better but not totally dry. Recovery is different for all guys and hopefully you husband will land on the drier side. You just never know, but hope for the best.

I echo the previous comments and wish to add another: Kegal, Kegal, Kegal. I began them even before I officially decided on surgery and continue them today. Every morning I try to do the Kegal exercises for about 5-10 minutes. Prior to surgery, I would do them a few times a day, many times while driving. I have been very fortunate, and have put the depends and male pads in the closet, to save for when I get into my 80's! As others have mentioned, I don't have the longevity any more, and appreciate when traveling with my wife when she says she wants to find a restroom NOW. Initially when I resumed my high school sports officiating, I wore a small women's pad, just in case and to avoid any accidents, but now I've discarded those. Bottom line, I feel exercise, both physical and Kegals have been the thing for me.

I asked my daVinci surgeon about the anatomy of incontinence - here's his reply:

In surgery you:- traumatize the sphincter at the bladder neck by cutting the prostate offthe bladder(this is an involuntary sphincter and takes time to recover)- leave the pelvic floor muscles alone (these are strengthened with Kegals)- remove the prostate (which contains some smooth muscles and createsresistance to flow)

So, you go from 3 muscles to one (with an injured bladder neck helping outa little). This is why doing pelvic floor exercises helps. As pelvicfloor muscles strengthen and as the bladder neck recovers, urinary controlimproves.

**"Report to the Nation on Prostate Cancer" published by the Prostate Cancer Foundation, page 11: "In some cases, the pathologist might identify a third pattern, which is less common but that has a higher grade than either of the first two patterns that comprised the Gleason score. The presence of this third pattern might indicate that the tumor is more aggressive than the Gleason score would otherwise imply. For example, if a Gleason 4+3 tumor also has some grade 5 cells, the cancer would be considered as being of higher grade disease overall."